Dental and surgical retractors, elevators which are push/pull instruments are used to manipulate various regions of the patient's skin, flesh or tissue. Using such an instrument, flesh or tissue may be folded or held away from a location where a dental or surgical operation or other intervention is being performed. In the dental industry retractors, elevators and other instruments are used most commonly to push or pull the patient's cheeks, tongue and soft tissues from the site where the operator is working. Retractors which pull away and elevators which push away these portions of flesh realize the following objectives: The body cavity wherein the operation is being performed is increased in size, thus allowing for more room in which to perform the procedure, concomitantly it allows for more room to maneuver the operating and diagnostic tools. Additionally, by pulling this flesh away from the operating work site, better visibility is achieved as more light is able to enter the cavity where the operator is working. Another function is to separate tissue from the underlying architecture and soft tissue related to the surgical site, giving access to previously covered areas.
Surgical instruments are typically comprised of two permanently fastened parts, the first part being a body or handle portion and the second part being a blade portion. This body or handle portion is held by the operator when using the retractor. The blade can be curved to lift portions of the skin or soft tissues, or hook around the tongue. By inserting a hook-shaped blade into an open cavity, and then rotating it, the surrounding tissues or the tongue thereby grasped can be retracted and pulled out of the working environment.
A single retractor blade size and shape design is usually too limited to perform all possible retracting functions. It has instead proven much better to use a plurality of differently shaped and sized retractors, elevators which are adapted to handle different types and masses of body tissues. The variety of sizes and shapes that can be used to perform retracting and reflecting functions are very numerous. These can range from large hook shaped instruments, to small perio-ostial elevator shapes that separate tissue from the underlying foundation. This variety of needs has required dentists, surgeons and others in the medical field to use different retractors, elevators and assorted instruments during different procedures.
Sufficient illumination of the mouth and other body cavities is also required to properly conduct dental, surgical and many other procedures. Accordingly, these instruments are typically used in conjunction with lighting systems wherein the retractor holds the body tissue out of the way while a lighting system concurrently illuminates the body cavity produced. Often in dental situations, relying on directed lighting external to the mouth can provide problems due to difficulties projecting the light in the required direction and thus create shadows which are cast onto the operating field. The use of separate retracting and lighting systems can cause inconvenience for the operator who is forced to simultaneously manipulate both systems. Various problems may occur when these separate lighting and retracting tools get in the way of each other and also of other equipment at the working environment. As a result, some systems have sought to integrate both of these functions into a single illuminated operating device. Unfortunately, these systems have all tended to emit narrow spot beam of light which is directed at a rather small location at the operating site. As the retractor is moved, as is necessary to perform its very retracting function, the narrow spot beam of light produced by these illuminated retractors is concurrently moved around the cavity in various directions. Consequently, the competing needs to properly position both the illumination function and the retractor function have tended to limit the effectiveness of these illuminated operating systems.
A system exists for use in the dental industry as a saliva ejector which may carry a source of light illuminating a patient's mouth when the instrument is in use. U.S. Pat. No. 2,161,151 to Hyman is an example of such a system. As the primary function of this system is to remove saliva from the patient's mouth, the ejector must be positioned to receive the pooling of saliva in the lower portion of the mouth . Accordingly, the Hyman system could not be used as a general purpose retractor in he surgical or dental fields, as the Hyman system is not at all designed to act as a movable retractor as it must remain relatively stationary and directed downwards in the patient's mouth.
A dental appliance exists for tongue stabilizing and debris removal from the mouth during the performance of dental procedures, as is found in U.S. Pat. No. 5,152,686 to Duggan, et al. This apparatus includes a bite block mad of a formable material and is uniquely formed to mold with the shape of the mouth cavity in the region of the tongue. This specialized device is not designed to be used as a general purpose dental or surgical retractor, nor is it adapted to be used at any location on the body, other than the mouth.
A system exists for holding and directing the beam of high intensity light sources, such as halogen or krypton gas-filled lamps, during dental or surgical procedures. An example of such a system is found in U.S. Pat. No 5,457,611 to Verderber. This system is not adapted to act as any sort of retractor, but simply direct a narrow spot beam towards a particular location.
A dental device exists for emitting light beams to measure the depth of gum pockets. An example of such a system is found in U.S. Pat. No. 5,271,734 to Takeuchi. This device uses a plurality of light emitting notches or grooves near the probe tip, these notches being spaced to form a rule. This device is not adapted to be used as a dental or surgical retractor.
A variety of illuminated surgical retractors exist which can be used to illuminate the interior of a natural body cavity or a cavity formed by an incision or wound. An example of such a system is found in U.S. Pat. No. 4,337,763 to Petrassevich. The device provides illumination from a light bulb location found somewhat to the rear of the blade. Altering the position of the retractor correspondingly alters the position towards which the light beam is directed. This system does not provide a plurality of interchangeable blades of different sizes and shapes. In addition, this illuminated retractor does not provide a diffused light, but rather the light is directed from a fixed point source.
Another example of a light directing surgical retractor instrument is found in U.S. Pat. No. 2,840,070 to Tofflemier. This device mounts a lamp at the rear face of a parabolic-shaped reflector which operates to focus and direct the light to where it is needed. This device has a curved portion which operates as a retractor, while the lamp and parabolic mirror are positioned on the inside of the tissue to be retracted. This device does not provide a diffuse light, but rather provides a concentrated directed beam. In addition, this device is limited in the particular uses to which it can be put, due to its unusual non S-shape, its large bulky nature, and the fact that a large parabolic mirror is attached to its end. In contrast, typical dental or surgical retractors typically end in a much sharper point end which is used for probing and separating the body's tissue
A final example of an illuminated surgical retractor is found in U.S. Pat. No. 2,296,793 to Kirschbaum. This device consists of a body portion and a blade with a lamp embedded in the blade. The blade is hollow with the bulb being located at a point where direct rays pass down to the end of the blade and out through a small transparent closure at the end of the blade. The Kirschbaum system has several limitations. First, the light emitted from the retractor is emitted only through a small opening at the end of the retractor's blade. This design presents two problems. First, the Kirschbaum system does not provide a gentle, even and diffused light illuminating the entire cavity into which it is placed. Rather, only a narrow directed spot beam passes out of the end of the blade. As this retractor is moved, the light beam will correspondingly be moved in direction. Secondly, as the light beam is emitted only from the retractor at the end of its tip, this will tend to block the beam when the retractor is in use, as the end of the retractor will be placed against or dug down into the body tissue which is to be pulled by the retractor. Accordingly, the light source will tend to become obscured when the lighted end tip of the blade becomes immersed in blood or tissue.
Consequently, the need exists for an illuminated instrument that provides a gentle diffused light rather than a narrow directed spot beam to the body cavity, thus operating as a diffused light which will more evenly illuminate a much wider area of the dark cavity in which the operation is being performed than can be done with previous narrow directed beam systems. The objective is to supply a well dispersed and relatively even illumination to the work area while performing the function of the dental/surgical retractor. The blades do a specific chore, they are designed to be the desired instrument needed for a specific modality. The unique frosting of the bladed instrument creates a very even source of light not blinding to the user. The emitted light is very diffuse in nature penetrating the deeper tissues, creating the ability to see in and through the tissues in the operating environment. The light emitted by this instrument is well dispersed and relatively even in intensity which is not hard on the eyes of the operator. This illuminated device will also perform all the functions of a dental, surgical retractor or elevator. This device has a blade shaped specifically for hooking around and pulling back, dragging or lifting and/or pushing or pulling body tissues. The light source is found within the body of the blade of the instrument, it is not located so close to the tip of the blade that the light source will tend to become obscured when a lighted tip of the blade becomes immersed in body and tissue fluids.
Furthermore, an assortment of differently sized and shaped illuminated blades will also be provided to perform the various required functions presently performed by a set of conventionally sized and shaped instruments. These illuminated blades will preferably also be freely interchangeable with the handle of the body portion of this instrument. It is also preferable when providing this plurality of differently shaped blades, to provide a blank blade made up of the same material as other blades which can be quickly and easily formed, at the job site, to shape and thereby be a customized blade for use in the device. Lastly, it is also preferable to have this illuminated system cordless so that it can be easily held and manipulated by an operator, free from the problems of the cumbersome cords that could possibly tangle with other equipment.
In view of the limitations of the prior art, there is a need for illuminated dental and surgical retractor that provides a handle that is adapted to carry any of a plurality of differently designed blades, wherein each blade provides an internally mounted bulb capable of providing a diffused illuminating light.